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Step by Step, Losses Add Up to Gains

Times Staff Writer

Sheila Tehrani dropped 48.2 pounds in four hours the other day.

That brought her down to a comparatively svelte 387 pounds, the first time in years that she's weighed less than 400.

The instant weight loss happened because surgeon Carson Liu sliced off loose belly skin that had draped to Tehrani's knees in the wake of her losing 144.2 pounds over the last 14 months.

When she awoke from the anesthesia, the extremities she hadn't been able to see without a mirror came into view — her own legs and toes.

"All I could think of is … my thighs look really fat," Sheila, 39, managed to joke the day after the surgery, despite throbbing pain from her 4-foot hip-to-hip scar. The drooping skin, she said, had made walking and driving difficult.

Tehrani's flesh was whisked away in coolers to the airport, en route to the nonprofit Musculoskeletal Transplant Foundation in New Jersey, which plans to purify and reuse the inner layer of the skin for hernia, pelvic and other reconstructive surgical procedures.

The lop-off marked the latest chapter in the journey back to health for Sheila and her brother Cyrus Tehrani, Eagle Rock siblings who underwent Lap-Band surgery last year after a cardiologist warned them that their weight (he tipped the scales at 578, she at 579) was threatening their lives.

The decision came after Cyrus, now 35, was hospitalized for several days in February 2005 with high blood pressure, leg swelling and breathing problems caused by the excess weight. The siblings refinanced their childhood home to pay for both of them to have bariatric surgery, in which a synthetic ring is used to reduce stomach capacity and make it impossible to eat large quantities.

In the year since his surgery, Cyrus has lost 172 pounds, and now weighs 406 pounds. Sheila weighed in at 434.8 before last week's surgery.

A Column One article in The Times in January transformed the Tehranis into minor celebrities, with appearances on the Discovery Health Channel and shows such as "Good Morning America" and "Entertainment Tonight/The Insider" (which dubbed them the "half-ton Hollywood siblings," much to the Tehranis' dismay).

In the months since the first surgery, Sheila said recently, she has joked with the weight-loss surgery support group she and Cyrus attend that she was there "to make Cyrus look better," because he was losing so much more. She said she struggled more with emotional issues that made it tough to eat less.

Cyrus now steadfastly refuses to eat sweets and most carbohydrates.

The night before he took wife Karen and four of his six children to Disneyland recently — the first time he could fit on rides since his 20s — Cyrus told Sheila he was thinking of having funnel cakes. His sister, who advocates careful portion control rather than absolute denial, encouraged him to go ahead. He opted for a chocolate-dipped banana instead and then ate only half because he actually felt sick with guilt.

On her birthday in April, Sheila craved the cream-and-strawberry cake from Ruby Bakery in Eagle Rock. Her family obliged but cut her a piece "you could practically see through," she said. But those few bites kept her from feeling deprived.

"I'm not like Cy — diligent and militant like he is — because I'm afraid if I'm like that, you'll find me covered in wrappers, having eaten myself to death," she said.

About two months ago, Liu tightened Sheila's Lap-Band for the second time since he implanted it, further cinching her stomach and reducing the amount of food she can ingest. (Cyrus will have his first tightening Wednesday.)

The tightening helped, she said. She couldn't eat much, and she loved the difference on the scale. She lost 26 pounds in the next two months. Exercising also has helped. She finally got a long-talked-of treadmill, though finding a portable one that could accommodate her weight wasn't easy.

With the machine set at 1 mile per hour, she at first could only walk for about 10 minutes. She has now worked her way up to 20 minutes at 1.7 mph a few times a week.

When she mentioned to family members that her sneakers were rubbing against her skin, they all went out separately and bought her socks — about a dozen pairs in all. The rest of the Tehrani clan didn't want her to have any excuse for not exercising.

"I'm the luckiest girl," she said of her family's support.

Her aunt and uncle gave her a 5-year-old Honda Accord. She gave up driving about eight years ago, when she could no longer fit behind the wheel of her Toyota pickup.

But her distended stomach still made it impossible to fit behind the wheel. At just 5 foot 2, she couldn't reach the gas and brake pedals if she pushed the seat back far enough so she could sit.

Trying on clothes for the first time in years at Catherines Plus Sizes in Pasadena, she saw herself in the full-view mirror. She says that was what cemented her decision to take Liu up on his offer to remove that huge band of flesh at no charge, because Sheila has no health insurance. Westside Multispecialty Surgery Center donated its facilities and services.

Cyrus' 9-year-old son Gavin hugged Sheila's belly as the surgery date neared, teasing, "I'm going to miss him."

That surgery marked the first time Sheila and Cyrus — the only children of parents who divorced when the siblings were 3 and 7 — wouldn't be doing something together since deciding to get the Lap-Band.

People who lose hundreds of pounds often are left with loose skin that may be removed surgically. Sheila may face more such surgery as she loses more weight. The more muscular and taller Cyrus didn't put on most of his weight till his 20s and hence doesn't have as much distended tissue.

On the morning of the operation, Cyrus drove Sheila to the surgery center. As Sheila left the waiting room, she and Cyrus didn't say goodbye, but he gave her a high-five.

As "Entertainment Tonight" and KNBC-TV Channel 4 television cameras and a Times reporter and photographer watched, Liu and the surgical team propped up the giant mass of flesh with 6-inch clips that seemed too small to handle the mountain of flesh, balled up like a huge supermarket turkey.

They soon found that the massive flesh tire, a pannis in medical terminology, was nourished by far more blood vessels than usual. Veins the width of pinkie fingers — about 10 times normal size — squirted blood.

Sheila's skin was as tough as leather from cellulitis, a common condition in obese people in which bacteria lodges under buckled skin.

By the end of the surgery, Liu had gone through eight scalpels because the tiny blades dulled so quickly.

After the skin and some underlying fat had been removed, Liu and his staff divided the mass into two parts. The first piece resembled a side of beef and weighed 25.4 pounds. The other side weighed 22.8 pounds. Liu also found a hernia buried in the fat in her upper torso, which he repaired. She had not felt it because there was so much fat.

Liu had to reposition her belly button, carving a new opening for it in what would become her mid torso.

Liu and assistant Dr. Gerald Glantz then spent about an hour stitching up the 4-foot incision, bringing the four-hour procedure to an end.

As Cyrus walked back to see Sheila soon after she awoke in recovery, he stopped in a room where two of the surgical team members were downing pizza. "Do you know how much of a morale boost this is going to be for her?" he said excitedly as he thanked them.

Sheila moaned in pain when she caught sight of Cyrus. "It's bad," she said tersely.

Suddenly, tears welled in Cyrus' eyes as he looked at her. The "anxiety of it all, now that it's over" had finally hit him, he said.

In the days since the surgery, Sheila said, she has finally started feeling much better, and she's delighted that she'll have about 50 fewer pounds to haul around.

At least for now, though, she maintains that it "was the toughest 48 pounds I ever lost."

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The Times will continue to follow the Tehranis progress with occasional articles in the paper and on the website. The previous article and more photos are at latimes.com/superobese.

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